Toe amputations are performed for a variety of reasons. The most common reason is complication from toe infection due to diabetes. In this case, either the skin over the toe becomes irreparably damaged due to infection and gangrene, or the bone underneath becomes infected. Toe bone infections are difficult to treat with antibiotics given their limited blood supply, and it is easier and more effective in most cases to simply remove the infected bone from the body. Bone infections often spread from the toe to the foot, and pose a risk for further disease of the foot and even blood poisoning from bacterial toxins, which can be lethal. Another common reason for toe amputation is gangrene from poor circulation, which sometimes cannot be reversed even if circulation is restored to the rest of the leg and foot. One other reason for toe amputation is irreparable damage from a mangling or crushing injury. Finally, a less common reason is a painful toe that is severely deformed, not functional, and not easily reconstructed through reparative surgery.

Toe amputation surgery is usually quick, and does not generally lead to long term issues with walking or shoe fitting (unless all the toes are removed, in which case a shoe filler needs to be used). There are essentially three different levels the toe can be amputated at, usually corresponding with one of the three joints found in the toes, including the base of the toe. The decision of where to amputate the toe at depends on where the dead or infected tissue lies, as well where healthy skin exists to allow for a strong skin flap to exist at the end of the stump. Ideally, the skin on the bottom of the toe is used to create the end of the stump, as it is thicker and stronger. Sometimes this is not possible, especially if the skin on the bottom is diseased. If there is tissue damage all the way to the base of the toe, the bone behind the toe, called the metatarsal, may protrude too far out the hole created by the toe removal. In this case, some of the metatarsal bone needs to be removed to allow the skin to close over this site.

Toe amputations generally heal quickly. Complications can include further infection, and nonhealing of the site due to persisting poor circulation not anticipated before the surgery was planned, and may result in the need for amputation further back in the foot. On average, though, this procedure is very successful and leads to a relatively healthy foot that can potentially save limb and life.